摘要
目的:探讨滤泡性淋巴瘤(FL)患者的临床特点及预后相关因素。方法:回顾性分析2009年1月—2020年6月复旦大学附属中山医院血液科住院治疗的288例初诊FL患者的临床资料,分析其临床特点、生存及预后因素。结果:(1)中位年龄55岁,男141例,女147例。FL 1~2级占58.3%,FL 3A级占24.7%,FL 3B级占3.5%,复合FL占9.7%,其他(分级不明)占3.8%。83.7%住院治疗FL患者处于Ⅲ~Ⅳ期,41.7%骨髓受侵。(2)系统治疗总有效率为89.7%,完全缓解(CR)率为70.4%;24.1%患者2年内复发进展。(3)R-CHOP样组生存分析显示,3年总生存(OS)率为94.4%,3年无进展生存(PFS)率为71.5%;FL 1~3A级患者,终末疗效CR组和部分缓解(PR)组3年OS率分别为98.7%和96.3%(P=0.935),3年PFS率分别为79.4%和70.5%(P=0.284);FL 1~3A级患者,维持治疗组和非维持治疗组3年OS率分别为100.0%和98.1%(P=0.145),3年PFS率分别为88.4%和68.5%(P=0.040);FL 3B级及复合FL患者,维持治疗组和非维持治疗组3年OS率分别为100.0%和85.7%(P=0.308),3年PFS率分别为53.6%和81.3%(P=0.338)。(4)R-CHOP样组多因素分析发现,FL 3B级及复合FL(P<0.001)和ECOG评分≥1分(P=0.005)是OS的独立危险因素;ECOG评分≥1分是PFS的独立危险因素(P=0.022)。结论:FL多见于中老年人,接受R-CHOP样方案患者总体预后好。FL 1~3A级患者,终末疗效达CR和PR生存差异无统计学意义,维持治疗PFS获益,OS无明显获益;而FL 3B级和复合FL患者维持治疗可能无明显获益。
Objective:To investigate the clinical characteristics and prognostic factors of patients with follicular lymphoma(FL).Methods:We retrospectively analyzed the clinical characteristics,survival and prognostic factors of 288 newly diagnosed FL patients hospitalized at the Department of Hematology in Zhongshan Hospital Affiliated Fudan University between January,2009 and June,2020.Results:(1)Median age was 55 years with 141 males and 147 females.FL grade 1-2 accounted for 58.3%,grade 3 A accounted for 24.7%,grade 3 B accounted for 3.5%,composite FL accounted for 9.7%and unknown grade accounted for 3.8%.Ann Arbor stageⅢ-Ⅳaccounted for 83.7%of hospitalized FL patients and 41.7%patients had bone marrow involvement.(2)The overall response rate was 89.7%,complete remission(CR)rate was 70.4%;progression of disease in the first two years accounted for 24.1%.(3)In R-CHOP group,the 3-year overall survival(OS)rate was 94.4%,the 3-year progression-free survival(PFS)rate was 71.5%.Among FL grade 1-3 A patients,the 3-year OS rates of CR group and partial remission(PR)group at the end of treatment were 98.7%and 96.3%(P=0.935),the 3-year PFS rates were 79.4%and 70.5%(P=0.284).Among FL grade 1-3 A patients,the 3-year OS rates of the maintenance group and non-maintenance group were 100.0%and 98.1%(P=0.145),the 3-year PFS rates were 88.4%and 68.5%(P=0.040).For FL grade 3 B and composite FL patients,the 3-year OS rates of the maintenance group and non-maintenance group were 100.0%and 85.7%(P=0.308),the 3-year PFS rates were 53.6%and 81.3%(P=0.338).(4)Multivariate analysis showed that FL grade 3 B and composite FL(P<0.001)and ECOG score≥1(P=0.005)were independent risk factors of OS.ECOG score≥1 was an independent risk factor of PFS(P=0.022).Conclusion:FL is more common among middle-aged and elderly people and overall prognosis is promising.Among FL grade 1-3 A patients,there are no significant survival difference between CR and PR patients at the end of frontline immunochemotherapy.Maintenance therapy brings benefits for FL grade 1-3 A patients on PFS but not OS.FL grade 3 B and composite FL patients probably couldn’t benefit from maintenance therapy.
作者
阿孜古丽·麦合麦提
陈菲菲
任雨虹
王亚文
刘澎
AZIGULI Maihemaiti;CHEN Feifei;REN Yuhong;WANG Yawen;LIU Peng(Department of Hematology,Zhongshan Hospital,Fudan University,Shanghai,200032,China;Cancer Center,Zhongshan Hospital,Fudan University)
出处
《临床血液学杂志》
CAS
2022年第1期21-28,共8页
Journal of Clinical Hematology
关键词
滤泡性淋巴瘤
临床特点
生存
维持治疗
follicular lymphoma
clinical characteristics
survival
maintenance
